NPI | 1255394680 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 040235) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 208229) |
207R00000X Internal Medicine (Licence: CT 040235) | |
Enumeration Date | 2006-04-07 |
Last Update Date | 2013-05-31 |